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目的:探讨局部放疗联合全身化疗治疗局限期小细胞肺癌(limited-stage small cell lung cancer,LS-SCLC)的预后及相关因素分析。方法:回顾性分析107例LS-SCLC患者临床资料,统计各临床因素及物理参数。采用χ2检验进行近期疗效影响因素分析。采用Kaplan-Meier法计算生存率,Log-rank法进行单因素分析,采用Cox比例风险模型进行多因素分析。结果:107例患者治疗后总有效率(CR+PR)为87.9%(94/107),1年生存率为73.8%,2年为38.8%,3年为27.6%,中位生存期19个月。接受全身化疗患者的有效率为89.9%(89/99),高于未接受化疗的5/8,差异有统计学意义,χ2=5.206,P=0.023。单因素分析结果显示,肿瘤体积≤135.0cm3、治疗后达CR及PR、接受全身化疗和PTVD95>51.0Gy的患者预后较好,P<0.05;多因素分析结果证实,肿瘤体积、化疗、放疗范围、放疗剂量、GTV HI和PTVD95是影响患者预后的独立因素,P<0.05。结论:对接受放化综合治疗的LS-SCLC患者,肿瘤体积较小、接受全身化疗、对累及肿瘤照射同时对原受累区预防照射、放疗剂量>56.0Gy、GTV HI≤1.05和PTV D95>51.0Gy是影响预后的临床和物理因素。
Objective: To investigate the prognosis and related factors in patients with limited-stage small cell lung cancer (LS-SCLC) under local radiotherapy combined with systemic chemotherapy. Methods: The clinical data of 107 patients with LS-SCLC were retrospectively analyzed. The clinical parameters and physical parameters were calculated. The χ2 test was used to analyze the influencing factors of short term efficacy. Kaplan-Meier method was used to calculate the survival rate, Log-rank method was used to perform univariate analysis and Cox proportional hazards model was used to perform multivariate analysis. Results: The total effective rate (CR + PR) of 107 patients was 87.9% (94/107) after treatment. The 1-year survival rate was 73.8%, 2 years was 38.8%, 3 years was 27.6%, and the median survival time was 19 month. The overall response rate was 89.9% (89/99) in patients receiving systemic chemotherapy, which was significantly higher than 5/8 without chemotherapy (χ2 = 5.206, P = 0.023). Univariate analysis showed that the prognosis of patients with tumor volume ≤135.0cm3, CR and PR after treatment, systemic chemotherapy and PTVD95> 51.0Gy was better, P <0.05; multivariate analysis confirmed that tumor volume, chemotherapy and radiotherapy range , Radiotherapy dose, GTV HI and PTVD95 were independent prognostic factors, P <0.05. CONCLUSIONS: In LS-SCLC patients receiving radiotherapy and radiotherapy, the tumors were relatively small in size and underwent systemic chemotherapy. Radiation doses of> 56.0Gy, GTV HI≤1.05 and PTV D95> 51.0 Gy is a clinical and physical factor that affects prognosis.